Kornimate/medical-research-clean huggingface dataset:
radiofrequency ablation of the superior cluneal nerve

Conditions: Nerve Entrapment Syndrome; Radiofrequency Ablation; Low Back Pain

Summary: low back pain is one of the most common musculoskeletal disorders affects individuals at least one during lifetime. chronic low back pain (clbp) lasts more than 3 months and decreases quality of life and causes work loss all over the world. most common causes of chronic low back pain (clbp) are lumbar disc herniation and/or degeneration, degenerative facet joints and sacroiliac joint pathologies, however, superior cluneal nerve (scn) entrapment is another cause of clbp that is ignored. it was reported that superior cluneal nerve entrapment prevalence is % 1,6 - % 14 in clbp patients. the cluneal nerves originate from the cutaneous branches of the dorsal ramus at t11-l4 and scn innervates the skin of the upper part of the gluteal region. the nerves pass over the iliac crest through a tunnel formed by the thoracolumbar fascia and the upper edge of the iliac crest, that is the entrapment area. there are methods such as nerve blocks, neuromodulations and surgery in resistant cases. however, scn entrapment is an overlooked diagnosis that should be considered in differential diagnosis. recently, radiofrequency ablation (rfa) of the scn was performed under fluoroscopic guidance, total of 78% of patients reported nearly full analgesia for an average of 3 months. although ultrasound-guided imaging and blocking of scn is well described, there was not enough study that shows the effectiveness of ultrasound-guided scn rfa and compares it to conventional physical therapy (cpt) in the treatment of clbp.


Eligibility criteria:
inclusion criteria: 1. suffering from chronic low back pain more than 3 months 2. age ≥ 18 3. vas score ≥ 3/10 4. according to the blood samples, there should not be any detected bleeding diathesis (inr ≤1.2) 5. patients detected positive 'iliac crest sign' included in the study exclusion criteria: 1. patients have pain score \<3 according to the visual analog scale (vas) 2. inr \>1.2 in blood samples 3. radicular pain accompanying progressive neurological deficit 4. sphincter disorder due to neurologic conditions 5. local infections 6. sepsis 7. malignancy 8. uncontrolled diabetes or other comorbidities leading general condition disorders 9. allergic history related to used materials 10. pregnancy 11. mental disorders worsen cooperation were excluded from the study.

Keywords: nerve entrapment syndrome radiofrequency ablation low back pain
wait and see antibiotic prescription for acute otitis media: a randomized controlled trial

Conditions: Otitis Media

Summary: to determine if a wait and see prescription for ear infections in childhood reduces use of antibiotics compared to an immediate prescription

we conducted a randomized, controlled trial evaluating a consecutive series of children diagnosed with aom during a one year period in an urban pediatric emergency department, utilizing diagnostic recommendations from contemporary evidence-based guidelines. the objectives of the study were to determine whether treatment of aom using a "wait and see prescription" (wasp) significantly reduces use of antimicrobials compared with a "standard prescription" (sp) and to evaluate the effects of this intervention on clinical symptoms and adverse outcomes related to antibiotic use.

Eligibility criteria:
inclusion criteria: * children between the ages of 6 months - 12 years who were diagnosed with acute otitis media exclusion criteria: * clinician suspicion or diagnosis of a concurrent bacterial infection * patient appeared "toxic" as determined by the pem clinician * patient was hospitalized * history of compromised immunity * patient was treated with antimicrobials in the preceding seven days * either tympanic membrane was perforated * myringotomy tubes were present * uncertain access to medical care * primary language of the parent or guardian was neither english nor spanish * prior enrollment in the study

Keywords: otitis antibiotic prescription
computed tomography (ct) - guided brachytherapy versus transarterial chemoembolization in patients with unresectable hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma

Summary: percutaneous, image-guided tumor ablation has evolved as a genuine alternative for the treatment of unresectable hepatocellular carcinoma. published data exploring stereotactic or proton beam percutaneous irradiation have revealed,that hepatocellular carcinoma (hcc) is radiosensitive to certain protocols. in phase i and ii studies, the investigators investigated the potential role of local irradiation in primary and secondary liver tumors employing a iridium192 source. the promising results of previous studies indicate that ct-guided brachytherapy might play a role in the treatment of unresectable hcc. therefore, the investigators started a randomized, controlled, clinical phase-ii study to evaluate the efficacy and survival-benefits of brachytherapy versus transarterial chemoembolization in patients with unresectable hcc.


Eligibility criteria:
inclusion criteria: * diagnosis of hcc by histopathology or according to the criteria of the consensus conference of the european association for the study of liver disease * unresectable hcc * karnofsky-index \> 70 * estimated life expectancy \> 16 weeks * adequate bone marrow function * adequate contraception for female patients * informed consent exclusion criteria: * portal vein thrombosis on the tumor side * extrahepatic spread * child c * other untreated malignant disease * general contraindication for chemotherapy * active infectious disease * neuropathy, platin-allergy * pregnancy

Keywords: percutaneous treatment
prophylactic reinforcement of ventral abdominal incisions trial

Conditions: Open Midline Laparotomy

Summary: this trial is being conducted to evaluate the efficacy of phasix™ mesh implantation at the time of midline fascial closure compared to primary suture closure in preventing a subsequent incisional hernia in subjects at risk for incisional hernia after open midline laparotomy surgery.

subjects will be randomized (1:1) to one of the two treatment groups in the operating room after fascial closure.

Eligibility criteria:
inclusion criteria: 1. must be ≥ 18 years of age 2. elective, open midline laparotomy ≥ 5 cm 3. willing and able to provide written informed consent 4. hernia risk equal to moderate or greater exclusion criteria: 1. previous hernia repair 2. emergent surgery 3. creation of skin flaps is preplanned 4. preplanned 2nd surgery 5. active skin pathology 6. life expectancy less than 36 months 7. pregnant or planning to become pregnant 8. receiving a medication/medical condition that may adversely affect wound healing 9. asa class \> iv 10. enrolled in another clinical trial 11. site personnel directly involved with this trial 12. any condition that would preclude the use of the device or the subject form completing the follow-up requirements 13. known or suspected allergy to tetracycline hydrochloride or kanamycin sulfate 14. two separate incisions are created 15. prior onlay mesh 16. surgeon is unable to fully close the fascia 17. the surgery requires more than a single piece of mesh 18. contraindication to placement of mesh 19. cdc class iv/active infection 20. breastfeeding
well-being and health-related quality of life in cancer patients and survivors during the covid-19 pandemic

Conditions: COVID-19 Infection; Hematopoietic and Lymphoid Cell Neoplasm; Malignant Solid Neoplasm

Summary: this study investigates the well-being and health-related quality of life in cancer patients and survivors during the covid-19 pandemic. using questionnaires may help researchers gain an understanding of how experiences during the covid-19 pandemic (e.g., exposure, risk factors, testing, isolation, seropositivity, hospitalization, loss of family or friends, loss of income), may impact multiple domains of health-related quality of life (physical, emotional and social well-being), and other areas such as covid-19-specific psychological distress (e.g., fear, anxiety and depressive symptoms), and disruptions to health care, finances, and social interactions.

primary objectives: i. assess experiences during the coronavirus disease 2019 (covid-19) pandemic (e.g., exposure, risk factors, testing, isolation, seropositivity, hospitalization, loss of family or friends); covid-19-specific psychological distress (e.g., fear, anxiety and depressive symptoms); health, financial and social disruptions; perceived benefits and social support; and health-related quality of life (hrqol) in a convenience sample of cancer patients and survivors. ii. evaluate the extent to which covid-19 experiences are associated with covid-19-specific psychological distress, health, financial and social disruptions, perceived benefits and social support, and hrqol. iii. evaluate the extent to which resiliency factors such as social support and perceived benefits moderate the effects of covid-19 experiences on covid-19-specific psychological distress and hrqol. outline: patients complete an online questionnaire over 10 minutes regarding the covid-19 pandemic including testing, risks of exposure, whether people they know have acquired covid-19, as well as questions on how the pandemic has impacted their quality of life.

Eligibility criteria:
inclusion criteria: * md anderson active patient (visit within past 5 years) * icd-10 confirmed cancer diagnosis * documentation of being alive per the cancer registry * patients who have signed consent for one of the following protocols: pa14-0241 or lab03-0320 * has an active email address and/or can be contacted via mychart * english or spanish speaker exclusion criteria: * non-active patient (i.e., no visit within past 5 years) * language other than english or spanish * patients who have previously consented to the following protocols: 2012-0112, 2009-0976, 2005-0035, or pa15-0336, because they will be contacted through separate irb protocols to complete this same survey
effect of an oral supplement on the total energy and protein intake of head and neck cancer patients in the last 2 weeks of radiation therapy

Conditions: Head and Neck Cancer

Summary: in this study, an oral nutrition supplement has been developed that take into consideration: the nutritional requirements, treatment side-effects and taste preferences of head and neck cancer patients; the acceptance of a supplement when experiencing radiation therapy side-effects; and the taste preferences of head and neck cancer patients which may affect the supplement intake. we hope to increase dietary intake during the last 2 weeks of radiation therapy.


Eligibility criteria:
inclusion criteria: * 18 years or older * diagnosed with head and neck cancer including the lip, oral cavity, salivary glands, paranasal sinuses, oropharynx, nasopharynx, hypopharynx, larynx and thyroid. * all histologic types of cancer * all tumour stages according to american joint committee for cancer (ajcc) staging * all forms of rt including standard or investigational for head and neck cancers * alert and mentally competent * english speaking exclusion criteria: * an allergy or intolerance to any of the substances used in the nutrition supplement * type i or ii diabetes mellitus * renal insufficiency * unable to swallow * additional criteria of all forms of chemotherapy standard or investigational or combination of radiation/chemotherapy standard or investigational for head and neck cancers

Keywords: food diet oral supplement head and neck cancer radiation
examining rehabilitation training methods

Conditions: Guided Training; Directed Training

Summary: individuals with cognitive impairments after stroke sustain significant disability in their daily tasks, and account for a significant proportion of stroke-related healthcare costs. this loss of independence is costly because individuals with stroke-related cognitive impairments require more rehabilitation and more resources to support their living, whether in institutional or community settings. the proposed study examines the effects of directed and guided training on the recovery of independence with daily activities in adults with stroke-related cognitive impairments in acute rehabilitation. the investigators predict that patients in both groups will demonstrate significant improvement in independence with daily activities in the first 12 months after rehabilitation admission, but that patients who receive guided training will demonstrate significantly more improvements than patients who received directed training.


Eligibility criteria:
inclusion criteria: * primary diagnosis of acute stroke * admission to acute inpatient rehabilitation * impairment in cognitive functions (as indicated by 14-item executive interview ≥ 3) exclusion criteria: * diagnosis of dementia in the medical record * inability to follow two-step commands 80% of the time * severe aphasia (score of 0 or 1 on the boston diagnostic aphasia examination 3rd edition severity rating scale) * current untreated major depressive, bipolar, or psychotic disorder (prime-md) * drug or alcohol abuse within 3 months (mini-international neuropsychiatric interview)

Keywords: stroke rehabilitation cognition disability intervention
evaluation of multi-tined expandable electrode (mee) efficacy and safety in treatment of lumbar facet arthropathy by radiofrequency neurotomies compared to conservative medical management.

Conditions: Chronic Low-back Pain

Summary: the purpose of this study is to better understand how people feel after a radiofrequency ablation standard of care surgery using a different type of needle (multi-tined expandable electrode/mee) in comparison to receiving conventional medical management (cmm) techniques.


Eligibility criteria:
inclusion criteria: * age \> 18 years old. * patients with pain lasting at least 6 months. * patients with history of non-radiating low back pain. * patient who had two diagnostic medial branch blocks (mbb) with significant (\>50%) improvement on both injections. * patient has signed study-specific informed consent. * patient has the necessary mental capacity to participate and is physically able to comply with study protocol requirements. exclusion criteria: * patient with low back pain with radiation or involvement of pain going into their legs below their knees. * patient did not receive satisfactory relief from diagnostic mbb (\<50% relief). * patient is unable to receive radiation exposure. * patient is currently pregnant. * patient has a current local overlying low back or systemic infection. * patient currently receiving or seeking workers compensation, disability remuneration, and/or involved in injury litigation. * known or suspected drug or alcohol abuse. * diagnosed psychiatric disease (e.g., schizophrenia, major depression, personality disorders) that could interfere with study participation. * patient is participating in an investigational study or has been involved in an investigational study within 3 months prior to evaluation for participation. * patient has an implanted intrathecal pump or spinal neuromodulation device. * patient currently on daily oral morphine equivalent (ome) of 50.
randomized evaluation of long term anticoagulant therapy (re-ly) with dabigatran etexilate

Conditions: Atrial Fibrillation; Stroke

Summary: the primary objective of this trial is to demonstrate the efficacy and safety of dabigatran etexilate in patients with non-valvular atrial fibrillation for the prevention of stroke and systemic embolism.


Eligibility criteria:
inclusion criteria patients with non-valvular atrial fibrillation (af), at moderate to high risk of stroke, or systemic embolism with at least one additional risk factor (i.e. previous ischemic stroke, tia, or systemic embolism, left ventricular dysfunction, age \>=75 years, age \>=65 with either diabetes mellitus, history of coronary artery disease or hypertension) exclusion criteria 1. prosthetic heart valves requiring anticoagulation per se, or hemodynamically relevant valve disease that is expected to require surgical intervention during the course of the study 2. severe, disabling stroke within the previous 6 months, or any stroke within the previous 14 days 3. conditions associated with an increased risk of bleeding 4. contraindication to warfarin treatment 5. reversible causes of atrial fibrillation (e.g., cardiac surgery, pulmonary embolism, untreated hyperthyroidism). 6. plan to perform a pulmonary vein ablation or surgery for cure of the af 7. severe renal impairment (estimated creatinine clearance \<=30 ml/min) 8. active infective endocarditis 9. active liver disease 10. women who are pregnant, lactating, or of childbearing potential who refuse to use a medically acceptable form of contraception throughout the study 11. anaemia (haemoglobin \<100g/l) or thrombocytopenia (platelet count \<100 x 109/l) 12. patients who have developed transaminase elevations upon exposure to ximelagatran 13. patients who have received an investigational drug in the past 30 days or are participating in another drug study 14. patients considered unreliable by the investigator concerning the requirements for follow-up during the study and/or compliance with study drug administration, has a life expectancy less than the expected duration of the trial due to concomitant disease, or has any condition which in the opinion of the investigator, would not allow safe participation in the study (e.g., drug addiction, alcohol abuse) 15. any known hypersensitivity to galactose if the warfarin used contains galactose.
preoperative octreotide treatment of acromegaly

Conditions: Acromegaly

Summary: the purpose of this study is to investigate whether 6 months preoperative treatment with the somatostatin analogue octreotide improves the surgical outcome in patients with acromegaly.

after a baseline evaluation, patients are randomized separately for each study center in blocks of four directly to transsphenoidal surgery or to 6-month preoperative treatment with octreotide. to reduce the risk of gastrointestinal adverse effects in the pretreatment group, octreotide is initiated at a dose of 50 µg sc three times a day for the 1st week and 100 µg sc three times a day for the 2nd week. from the 3rd week on, the patients receive octreotide lar (novartis international ag, basel, switzerland) 20 mg im every 28th day for 6 months. patients receive transsphenoidal surgery within 28 d of the last injection. if surgery are delayed, an extra octreotide lar injection is given before surgery.

Eligibility criteria:
inclusion criteria: * gh nadir during a standard 75 g ogtt \>= 5.0 mmol/l. * pituitary tumor by mri-scan. exclusion criteria: * immediate surgery indicated by usual clinical criteria. * pregnant. * known adverse effects of octreotide. * unfit for participation by any other reason.

Keywords: acromegaly
burden fatty liver among acute ischemic cerebral stroke patients

Conditions: Fatty Liver; Acute Ischemic Cerebral Stroke

Summary: 1. assess frequency of hepatic steatosis among patients in patients with ischemic stroke without previous risk factors 2. assess outcomes morbidity and mortality ischemic stroke in correlation with hepatic steatosis .

fatty liver disease, encompassing both alcoholic and non-alcoholic variants, is a growing health concern worldwide, with prevalence rates soaring in parallel with obesity and diabetes epidemics. the estimated global incidence of nafld alone is 47 cases per 1,000 people, with a higher rate observed in males than females. among adults worldwide, the estimated prevalence of nafld is 32%, with a higher prevalence in males (40%) compared to females (26%), making it the most common liver disorder. the hazards of fatty liver disease extend beyond the liver itself .the condition is characterized by the accumulation of excess fat in liver cells, which can progress to more severe liver diseases, such as steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. early assessment and diagnosis of liver steatosis are crucial for managing and mitigating the risks associated with fld. non-invasive methods, such as elastography combined with the controlled attenuation parameter (cap) score, have emerged as effective tools for detecting and quantifying liver fat content. these methods offer a less invasive alternative to liver biopsies, providing reliable data to guide clinical decisions. nafld is characterized by a proinflammatory and proatherogenic state that causes vascular inflammation and neurodegeneration, potentially leading to both clinical and subclinical cerebrovascular disease. increasing epidemiological evidence links nafld to a higher risk and greater severity of stroke, independent of other vascular risk factors.additionally, studies suggest nafld is involved in subclinical cerebrovascular diseases, such as carotid atherosclerosis which is characterized by the build-up of plaques in the carotid arteries. patients with nafld exhibited greater carotid atherosclerosis .

Eligibility criteria:
inclusion criteria: * newly diagnosed ischemic cerebral stroke exceeding of window phase without obvious risk factors. * patients above 18 years. * patients below 60 years. exclusion criteria: * patients have obvious risk factors including: smoking, dm , hypertension ,renal patients , cardiovascular diseases (af , valvular disease ,reduced systolic function ,chronic hcv ,hbv). * patients below 18 years. * patients above 60 years. * patients refused to contribute to this study.

Keywords: fatty liver acute ischemic cerebral stroke hepatic steatosis
online exercise program during perioperative treatment in adults with gastric cancer

Conditions: Gastric Cancer

Summary: perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin, and docetaxel (flot4) is the standard perioperative treatment for resectable and advanced gastric adenocarcinoma. although the flot4 regimen have shown increases in the overall survival, response rate, and progression-free survival, it is also associated with substantial toxicities. prehabilitation is an effective strategy to improve physical fitness in cancer patients and reverse functional limitations and inadequate levels of physical activity that are associated with worse postoperative outcomes and treatment response. therefore, the main objective of this study is to evaluate the effects of an online, supervised exercise-based prehabilitation program on the cardiorespiratory fitness level, functional fitness and quality of life among adults with gastric cancer undergoing neoadjuvant chemotherapy.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years. * willingness to participate in the study. * referral for surgical treatment for gastric cancer. * diagnosis of gastric cancer for curative intent - stage ii/iii * referall to the perioperative flot4 chemotherapy regimen * ecog ps 0-1. * receptiveness and availability to use the proposed technology for exercise sessions exclusion criteria: * inability to provide informed consent * inability to engage in physical training or perform the baseline walking test * presence of distant metastatic disease * history of previous or concurrent malignancy * diagnosis of heart failure, ischemic heart disease, or sinus node valvular disease * pregnancy.

Keywords: physical exercise gastric cancer prehabilitation perioperative cancer treatment